Адъювантная терапия остеоартрита биорегуляционными препаратами
https://doi.org/10.14412/1996-7012-2025-1-98-104
Аннотация
Остеоартрит (ОА) – хроническое прогрессирующее заболевание суставов, занимающее первое место по частоте среди болезней костно-мышечной системы. ОА представляет собой серьезную общемедицинскую и социальную проблему, связанную с неуклонным ростом его распространенности. Уменьшение боли при ОА, поддержание активной повседневной деятельности и сохранение социальной функции являются основной целью лечения практически всех пациентов, страдающих этим заболеванием. Наряду с известными традиционными методами лечения ОА существуют адъювантные методы терапии. Комплексные биорегуляционные препараты – это лекарственные средства исключительно природного происхождения, состав которых подобран эмпирическим путем. Препараты этой группы обладают противовоспалительным, иммуномодулирующим и противомикробным действием, а их эффективность и безопасность доказаны в масштабных клинических исследованиях.
Об авторах
Е. Г. ЗоткинРоссия
Евгений Германович Зоткин,
115522, Москва, Каширское шоссе, 34А
С. Ю. Шкиреева
Россия
115522, Москва, Каширское шоссе, 34А
Литература
1. Cui A, Li H, Wang D, et al. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020 Nov 26:29- 30:100587. doi: 10.1016/j.eclinm.2020.100587. eCollection 2020 Dec.
2. Lo J, Chan L, Flynn S. A systematic review of the incidence, prevalence, costs, and activity and work limitations of amputation, osteoarthritis, rheumatoid arthritis, back pain, multiple sclerosis, spinal cord injury, stroke, and traumatic brain injury in the United States: a 2019 update. Arch Phys Med Rehabil. 2021 Jan;102(1):115-131. doi: 10.1016/j.apmr.2020.04.001. Epub 2020 Apr 24.
3. Leifer VP, Katz JN, Losina E. The burden of OA-health services and economics. Osteoarthritis Cartilage. 2022 Jan;30(1):10-16. doi: 10.1016/j.joca.2021.05.007. Epub 2021 May 20.
4. Man G, Mologhianu G. Osteoarthritis pathogenesis – a complex process that involves the entire joint. J Med Life. 2014 Mar 15;7(1):37-41. Epub 2014 Mar 25.
5. Sokolove J, Lepus CM. Role of inflammation in the pathogenesis of osteoarthritis: Latest findings and interpretations. Ther Adv Musculoskelet Dis. 2013 Apr;5(2):77-94. doi: 10.1177/1759720X12467868.
6. Thomson A, Hilkens CMU. Synovial Macrophages in Osteoarthritis: The Key to Understanding Pathogenesis? Front Immunol. 2021 Jun 15:12:678757. doi: 10.3389/fimmu.2021.678757. eCollection 2021.
7. Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther. 2013;15 Suppl 3(Suppl 3):S2. doi: 10.1186/ar4174. Epub 2013 Jul 24.
8. Zhu X, Chan YT, Yung PSH, et al. Subchondral Bone Remodeling: A Therapeutic Target for Osteoarthritis. Front Cell Dev Biol. 2021 Jan 21:8:607764. doi: 10.3389/fcell.2020.607764. eCollection 2020.
9. Fu K, Robbins SR, McDougall JJ. Osteoarthritis: the genesis of pain. Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv43- iv50. doi: 10.1093/rheumatology/kex419.
10. O’Neill TW, Parkes MJM, Maricar N, et al. Synovial tissue volume: a treatment target in knee osteoarthritis (OA). Ann Rheum Dis. 2016 Jan;75(1):84-90. doi: 10.1136/annrheumdis-2014-206927. Epub 2015 Jun 26.
11. Batushansky A, Zhu S, Komaravolu RK, et al. Fundamentals of OA. an initiative of osteoarthritis and cartilage. Obesity and metabolic factors in OA. Osteoarthritis Cartilage. 2022 Apr;30(4):501-515. doi: 10.1016/j.joca.2021.06.013. Epub 2021 Sep 17.
12. Mobasheri A, Rayman MP, Gualillo O, et al. The role of metabolism in the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 2017 May;13(5):302-311. doi: 10.1038/nrrheum.2017.50. Epub 2017 Apr 6.
13. Long H, Cao R, Yin H, et al. Associations between obesity, diabetes mellitus, and cardiovascular disease with progression states of knee osteoarthritis (KOA). Aging Clin Exp Res. 2023 Feb;35(2):333-340. doi: 10.1007/s40520-022-02312-8. Epub 2022 Dec 16.
14. Berenbaum F, Griffin TM, Liu-Bryan R. Review: metabolic regulation of inflammation in osteoarthritis. Arthritis Rheumatol. 2017 Jan;69(1):9-21. doi: 10.1002/art.39842.
15. Dell’Isola A, Pihl K, Turkiewicz A, et al. Risk of comorbidities following physician-diagnosed knee or hip osteoarthritis: a registerbased cohort study. Arthritis Care Res (Hoboken). 2022 Oct;74(10):1689-1695. doi: 10.1002/acr.24717. Epub 2022 Jun 22.
16. Fonseca-Rodrigues D, Rodrigues A, Martins T, et al. Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford). 2021 Dec 24;61(1):53-75. doi: 10.1093/rheumatology/keab512.
17. Veronese N, Honvo G, Bruyere O, et al. Knee osteoarthritis and adverse health outcomes: an umbrella review of meta-analyses of observational studies. Aging Clin Exp Res. 2023 Feb;35(2):245-252. doi: 10.1007/s40520-022-02289-4. Epub 2022 Nov 4.
18. Veronese N, Stubbs B, Solmi M, et al. Osteoarthristis increases the risk of cardiovascular disease: data from the osteoarthritis initiative. J Nutr Health Aging. 2018;22(3): 371-376. doi: 10.1007/s12603-017-0941-0.
19. Perruccio AV, Zahid S, Yip C, et al. Cardiovascular Risk Profile and Osteoarthritis-Considering Sex and Multisite Joint Involvement: A Canadian Longitudinal Study on Aging. Arthritis Care Res (Hoboken). 2023 Apr;75(4):893-901. doi: 10.1002/acr.24826. Epub 2022 Nov 20.
20. Neogi T, Felson D, Niu J, et al. Association between radiographic features of knee osteoarthritis and pain: Results from two cohort studies. BMJ. 2009 Aug 21:339:b2844. doi: 10.1136/bmj.b2844.
21. Bacon K, Lavalley MP, Jafarzadeh SR, Felson D. Does cartilage loss cause pain in osteoarthritis and if so, how much? Ann Rheum Dis. 2020 Aug;79(8):1105-1110. doi: 10.1136/annrheumdis-2020-217363. Epub 2020 May 7.
22. Wang K, Kim HA, Felson DT, et al. Radiographic Knee Osteoarthritis and Knee Pain: Cross-sectional study from Five Different Racial/Ethnic Populations. Sci Rep. 2018 Jan 22;8(1):1364. doi: 10.1038/s41598-018-19470-3.
23. Malfait AM, Miller RE, Miller RJ. Basic Mechanisms of Pain in Osteoarthritis: Experimental Observations and New Perspectives. Rheum Dis Clin North Am. 2021 May;47(2): 165-180. doi: 10.1016/j.rdc.2020.12.002.
24. Clauw DJ, Hassett AL. The role of centralised pain in osteoarthritis. Clin Exp Rheumatol. 2017 Sep-Oct;35 Suppl 107(5): 79-84. Epub 2017 Sep 29.
25. Miller RJ, Malfait A-M, Miller RE. The innate immune response as a mediator of osteoarthritis pain. Osteoarthritis Cartilage. 2020 May;28(5):562-571. doi: 10.1016/j.joca.2019.11.006. Epub 2019 Dec 17.
26. Cedraschi C, Delezay S, Marty M, et al. “Let’s talk about OA pain”: A qualitative analysis of the perceptions of people suffering from OA. Towards the development of a specific pain OA-related questionnaire, the Osteoarthritis Symptom Inventory Scale (OASIS). PLoS One. 2013 Nov 11;8(11): e79988. doi: 10.1371/journal.pone.0079988. eCollection 2013.
27. Griffin TM, Scanzello CR. Innate inflammation and synovial macrophages in osteoarthritis pathophysiology. Clin Exp Rheumatol. 2019 Sep-Oct;37 Suppl 120(5):57-63. Epub 2019 Oct 15.
28. Deyle GD, Allen CS, Allison SC, et al. Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee. N Engl J Med. 2020 Apr 9;382(15):1420-1429. doi: 10.1056/NEJMoa1905877.
29. McAlindon TE, LaValley MP, Harvey WF, et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017 May 16; 317(19):1967-1975. doi: 10.1001/jama.2017.5283.
30. Buckley CD, Gilroy DW, Serhan CN, et al. The resolution of inflammation. Nat Rev Immunol. 2013 Jan;13(1):59-66. doi: 10.1038/nri3362. Epub 2012 Nov 30.
31. Schett G, Elewaut D, McInnes IB, et al. How cytokine networks fuel inflammation: toward a cytokine-based disease taxonomy. Nat Med. 2013 Jul;19(7):822-4. doi: 10.1038/nm.3260.
32. McInnes IB, Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis. Lancet. 2017 Jun 10;389(10086): 2328-2337. doi: 10.1016/S0140-6736 (17)31472-1.
33. Nielsen OH, Ainsworth MA. Tumor necrosis factor inhibitors for inflammatory bowel disease. N Engl J Med. 2013 Aug 22; 369(8):754-62. doi: 10.1056/NEJMct1209614.
34. Lämmermann T, Afonso PV, Angermann BR, et al. Neutrophil swarms require LTB4 and integrins at sites of cell death in vivo. Nature. 2013 Jun 20;498(7454):371-5. doi: 10.1038/nature12175. Epub 2013 May 26.
35. Levy BD, Clish CB, Schmidt B, et al. Lipid mediator class switching during acute inflammation: signals in resolution. Nat Immunol. 2001 Jul;2(7):612-9. doi: 10.1038/89759.
36. Sogawa Y, Ohyama T, Maeda H, Hirahara K. Inhibition of neutrophil migration in mice by mouse formyl peptide receptors 1 and 2 dual agonist: indication of cross-desensitization in vivo. Immunology. 2011 Mar;132(3): 441-50. doi: 10.1111/j.1365-2567.2010.03367.x. Epub 2010 Oct 29.
37. Uderhardt S, Herrmann M, Oskolkova OV, et al. 12/15-lipoxygenase orchestrates the clearance of apoptotic cells and maintains immunologic tolerance. Immunity. 2012 May 25;36(5):834-46. doi: 10.1016/j.immuni.2012.03.010. Epub 2012 Apr 12.
38. Uderhardt S, Ackermann JA, Fillep T, et al. Enzymatic lipid oxidation by eosinophils propagates coagulation, hemostasis, and thrombotic disease. J Exp Med. 2017 Jul 3; 214(7):2121-2138. doi: 10.1084/jem.20161070. Epub 2017 May 31.
39. McGrath EE, Marriott HM, Lawrie A, et al. TNF-related apoptosis-inducing ligand (TRAIL) regulates inflammatory neutrophil apoptosis and enhances resolution of inflammation. J Leukoc Biol. 2011 Nov;90(5): 855-65. doi: 10.1189/jlb.0211062. Epub 2011 May 11.
40. Brown SB, Savill J. Phagocytosis triggers macrophage release of Fas ligand and induces apoptosis of bystander leukocytes. J Immunol. 1999 Jan 1;162(1):480-5.
41. Gagliani N, Amezcua Vesely MC, Iseppon A, et al. TH17 cells transdifferentiate into regulatory T cells during resolution of inflammation. Nature. 2015 Jul 9;523(7559):221-5. doi: 10.1038/nature14452. Epub 2015 Apr 29.
42. Li MO, Sarkisian MR, Mehal WZ, et al. Phosphatidylserine receptor is required for clearance of apoptotic cells. Science. 2003 Nov 28;302(5650):1560-3. doi: 10.1126/science.1087621.
43. Kobayashi N. TIM-1 and TIM-4 glycoproteins bind phosphatidylserine and mediate uptake of apoptotic cells. Immunity. 2007 Dec; 27(6):927-40. doi: 10.1016/j.immuni.2007.11.011.
44. Huynh ML, Fadok VA, Henson PM. Phosphatidylserine-dependent ingestion of apoptotic cells promotes TGF-beta1 secretion and the resolution of inflammation. J Clin Invest. 2002 Jan;109(1):41-50. doi: 10.1172/JCI11638.
45. Wynn TA, Chawla A, Pollard JW. Macrophage biology in development, homeostasis and disease. Nature. 2013 Apr 25; 496(7446):445-55. doi: 10.1038/nature12034.
46. Ma WT, Gao F, Gu K, Chen DK. The Role of Monocytes and Macrophages in Autoimmune Diseases: A Comprehensive Review. Front Immunol. 2019 May 24:10:1140. doi: 10.3389/fimmu.2019.01140. eCollection 2019.
47. Sica A, Erreni M, Allavena P, Porta C. Macrophage polarization in pathology. Cell Mol Life Sci. 2015 Nov;72(21):4111-26. doi: 10.1007/s00018-015-1995-y. Epub 2015 Jul 26.
48. Csуka B, Selmeczy Z, Koscsу B, et al. Adenosine promotes alternative macrophage activation via A2A and A2B receptors. FASEB J. 2012 Jan;26(1):376-86. doi: 10.1096/fj.11-190934. Epub 2011 Sep 16.
49. Mao X, Xing H, Mao A, et al. Netrin-1 attenuates cardiac ischemia reperfusion injury and generates alternatively activated macrophages. Inflammation. 2014 Apr;37(2):573-80. doi: 10.1007/s10753-013-9771-3.
50. Gerlach BD, Ampomah PB, Yurdagul A Jr, et al. Efferocytosis induces macrophage proliferation to help resolve tissue injury. Cell Metab. 2021 Dec 7;33(12): 2445-2463.e8. doi: 10.1016/j.cmet.2021. 10.015. Epub 2021 Nov 15.
51. Perretti M, Leroy X, Bland EJ, MonteroMelendez T. Resolution pharmacology: Opportunities for therapeutic innovation in inflammation. Trends Pharmacol Sci. 2015 Nov; 36(11):737-755. doi: 10.1016/j.tips.2015.07.007. Epub 2015 Nov 2.
52. Barnig C, Frossard N, Levy BD. Towards targeting resolution pathways of airway inflammation in asthma. Pharmacol Ther. 2018 Jun:186:98-113. doi: 10.1016/j.pharmthera.2018.01.004. Epub 2018 Jan 20.
53. Fullerton JN, Gilroy DW. Resolution of inflammation: a new therapeutic frontier. Nat Rev Drug Discov. 2016 Aug;15(8):551-67. doi: 10.1038/nrd.2016.39. Epub 2016 Mar 29.
54. Serhan CN. Pro-resolving lipid mediators are leads for resolution physiology. Nature. 2014 Jun 5;510(7503):92-101. doi: 10.1038/nature13479.
55. Julliard WA, Myo YPA, Perelas A, et al. Specialized pro-resolving mediators as modulators of immune responses. Semin Immunol. 2022 Jan:59:101605. doi: 10.1016/j.smim.2022.101605. Epub 2022 Jun 2.
56. Kourtzelis I, Li X, Mitroulis I, et al. DEL-1 promotes macrophage efferocytosis and clearance of inflammation. Nat Immunol. 2019 Jan;20(1):40-49. doi: 10.1038/s41590-018-0249-1. Epub 2018 Nov 19.
57. Лила АМ, Мазуров ВИ, Мартынов АИ, и др. Резолюция консенсуса экспертов Российской Федерации по диагностике и лечению остеоартрита 2022. Современная ревматология. 2022;16(6):106-116. doi: 10.14412/1996-7012-2022-6-106-116
58. Алексеева ЛИ, Мазуров ВИ, Зонова ЕВ и др. Результаты клинического исследования препаратов Траумель® С и Цель® Т у пациентов с остеоартритом коленного сустава, имеющих сопутствующие сердечнососудистые заболевания. Современная ревматология. 2023;17(5):79-86. doi: 10.14412/1996-7012-2023-5-79-86
59. St Laurent G, Seilheimer B, Tackett M, et al. Deep Sequencing Transcriptome Analysis of Murine Wound Healing: Effects of a Multicomponent, Multitarget Natural Product Therapy-Tr14. Front Mol Biosci. 2017 Aug 17;4:57. doi: 10.3389/fmolb.2017.00057. eCollection 2017.
60. Jordan PM, van Goethem E, Müller AM, et al. The Natural Combination Medicine Traumeel (Tr14) Improves Resolution of Inflammation by Promoting the Biosynthesis of Specialized Pro-Resolving Mediators. Pharmaceuticals (Basel). 2021 Nov 3;14(11):1123. doi: 10.3390/ph14111123.
Рецензия
Для цитирования:
Зоткин ЕГ, Шкиреева СЮ. Адъювантная терапия остеоартрита биорегуляционными препаратами. Современная ревматология. 2025;19(1):98-104. https://doi.org/10.14412/1996-7012-2025-1-98-104
For citation:
Zotkin EG, Shkireeva SY. Adjuvant therapy of osteoarthritis with bioregulatory drugs. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2025;19(1):98-104. (In Russ.) https://doi.org/10.14412/1996-7012-2025-1-98-104